Clinical analysis of vascular injury induced by abdominal wall puncture under abdominal laparoscope

Abstract

Objective To investigate the causes, management and preventive measures of vascular injury induced by abdominal wall puncture under abdominal laparoscope in Department of Urology Surgery. Methods Clinical data of 6 of 1025 patients presenting with vascular injury induced by abdominal wall puncture during abdominal laparoscopic surgery from September 2012 to September 2017 in Department of Urology Surgery of our hospital were retrospectively analyzed. The causes were analyzed, and the management and preventive measures were summarized. Results Six cases of vascular injury occurred including 1 case of abdominal aorta injury, 1 case of right common iliac arterial injury, 4 cases of inferior abdominal wall vascular injury and 1 case of mesenteric arterial injury. The incidence rate of vascular injury was 0.585% (6/1025). Hemostasis was successfully performed under laparoscope in4 patients and 2 cases were switched to open surgery for hemostasis. Conclusion The vascular injury during laparoscopic abdominal wall puncture can be caused by multiple risk factors, such as abdominal adhesion, emaciation or obesity. Individualized evaluation should be delivered before operation. Deep understanding of abdominal vascular anatomy and standardized intraoperative procedures plays a pivotal role in reducing the risk of vascular injury. Mastering the clinical manifestations and effective management of vascular injury can mitigate the trauma and sequela to patients. Key words: Laparoscopy; Vascular injury; Management; Prevention